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Trial registered on ANZCTR
Registration number
ACTRN12615000631505
Ethics application status
Approved
Date submitted
19/05/2015
Date registered
17/06/2015
Date last updated
17/06/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
A phase II study of induction therapy using idarubicin and infusional high-dose cytarabine for adult patients with de novo untreated acute lymphoblastic leukaemia
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Scientific title
A phase II study to evaluate the effect of induction therapy using idarubicin and infusional high-dose cytarabine on mortality rate and haematological toxicity in adult patients with de novo untreated acute lymphoblastic leukaemia
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Secondary ID [1]
286754
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ALLG ALL3
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
acute lymphoblastic leukaemia
295112
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Condition category
Condition code
Cancer
295362
295362
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0
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Leukaemia - Acute leukaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1. Induction chemotherapy (1x 28 day cycle)
a. Cytarabine given as a 2 hour intravenous infusion at a dose of 3 gm/ m2 on day 1, followed by a continuous intravenous infusion beginning 12 hours after commencement of the initial dose for a total of 96 hours at a dose of 1.5 gm/m2 per 24 hours.
b. Idarubicin, given as an intravenous bolus at a dose of 12 mg/m2 on days 1, 2, and 3.
Supportive treatment consisting of Allopurinol 300 mg daily per oral given from day –2 until the white cell count is below 1.0 x 10^9/L, and Fluconazole 200 mg daily orally for 28 days as fungal infection prophylaxis. Filgrastim started on day + 6 at a dose of 5 microgram / kg daily by subcutaneous injection until the post-nadir neutrophil count exceeds 2.0 x 10^9/L.
One intrathecal injection of Methotrexate 12 mg given at the start of induction therapy. Induction therapy is 1x 28 day cycle.
2. Post-induction treatment (consolidation 1x 28 day cycle)
a. Cytarabine 3 gm/ m2 as an intravenous infusion over 2 hours, followed 12 hours later by a continuous intravenous infusion at a dose of 1.5 gm/m2 per 24 hours for 72 hours.
b. Idarubicin, as an intravenous bolus at a dose of 12 mg/ m2 daily on days 1 and 2.
Filgrastim from day +5 at a dose of 5 microgram per kg subcutaneously daily until recovery of the neutrophil count to greater than 2.0 x 10^9/L.
One injection of intrathecal Methotrexate 12mg given at the start of consolidation therapy.
The duration between induction and consolidation is 28 to 35 days.
Following consolidation with cytarabine and Idarubicin, a further course of therapy was given using high dose intravenous Methotrexate, as soon as practical after day 28 from the start of consolidation therapy. This consists of 3 g/m2 for 2 courses 14 days apart.
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Intervention code [1]
291907
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Treatment: Drugs
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Comparator / control treatment
No comparator/control treatment
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Induction death rate as measured by the percentage of patients dying
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Assessment method [1]
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Timepoint [1]
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4 weeks after commencing induction therapy
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Primary outcome [2]
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Incidence of grade 3 and 4 non-haematological toxicities according to the National Cancer Institute Common Terminology Criteria for Adverse Event Reporting vs 2
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Assessment method [2]
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Timepoint [2]
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4 weeks after commencing induction therapy
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Secondary outcome [1]
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Levels of residual disease using PCR-amplification of immunoglobulin gene rearrangements
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Assessment method [1]
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Timepoint [1]
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Days 14 and 28 after induction and after consolidation therapy
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Secondary outcome [2]
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Complete remission rate defined as patients meeting all the following criteria:
1. Absence of symptoms and signs of leukaemia.
2. Neutrophil count > 1.0 x 10^9/ L at least 5 days after ceasing filgrastim.
3. Platelet count greater than 100 x 10^9/ L
4. Absence of leukaemic cells in the peripheral blood
5. Normocellular bone marrow with active haemopoiesis and less than 5 % blasts.
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Assessment method [2]
314782
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Timepoint [2]
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After induction therapy
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Secondary outcome [3]
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Leukaemia-free survival
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Assessment method [3]
314783
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Timepoint [3]
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One and two years following induction therapy
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Eligibility
Key inclusion criteria
1. A diagnosis of acute lymphoblastic leukaemia by WHO criteria.
2. No prior therapy for ALL
3. Age 20 to 55 years inclusive.
4. Morphological subtypes FAB L1 and L2.
5. Precursor-B immunophenotype, including pre-B (cytoplasmic mu chain expression), and cases with myeloid antigen expression.
6. ECOG performance status 0 to 3 inclusive.
7. Adequate renal (serum creatinine < 150 micromols/L), hepatic (serum bilirubin <2 times upper limit of normal), and cardiac function (normal left ventricular ejection fraction as assessed according to institutional practice).
8. Not known to be seropositive for HIV.
9. Written informed consent to participate in the study.
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Minimum age
20
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Precursor T or mature B (surface Ig positive) phenotypes
2. Morphological subtype FAB L3
3. Cases which are known to be Philadelphia chromosome positive, or have detectable bcr-abl transcripts by RT-PCR.
4. Past history of cancer, other than non-melanoma skin cancer or carcinoma of cervix in situ.
5. Past history of serious cardiac, pulmonary, hepatic or renal disease.
6. Pregnancy or planned continued breast feeding.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
8/06/2002
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Date of last participant enrolment
Anticipated
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Actual
24/03/2005
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,QLD,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Amgen Australia, Pty Ltd
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Address [1]
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Level 7, 123 Epping Road,
North Ryde NSW 2113
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Pfizer Australia
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Address [2]
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38-42 Wharf Road West Ryde NSW 2114
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Country [2]
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Australasian Leukaemia and Lymphoma Group
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Address
Ground Floor, 35 Elizabeth Street, Richmond, VIC 3121
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
289972
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Country [1]
289972
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Peter MacCallum Cancer Centre
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Ethics committee address [1]
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St Andrews Place, East Melbourne, Vic 3002
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
292863
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Approval date [1]
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23/04/2002
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Ethics approval number [1]
292863
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Summary
Brief summary
The primary hypothesis is that an intensive chemotherapy protocol, incorporating high-dose cytarabine and Idarubicin, as originally designed for treatment of Acute Myeloid Leukaemia, when used in the treatment of adults with Acute Lymphoblastic Leukaemia, has acceptable tolerability and safety. The subsidiary hypothesis is that this regimen will result in a greater degree of reduction of the number of leukaemia cells, than conventional treatment.
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Trial website
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Trial related presentations / publications
There are not as yet any presentations or publications from this trial.
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Public notes
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Contacts
Principal investigator
Name
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Prof Ken Bradstock
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Address
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Westmead Hospital,
Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145
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Country
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Australia
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Phone
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+612-9845 7073
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Janey Stone
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Address
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ALLG, Ground Floor, 35 Elizabeth Street, Richmond, VIC 3121
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Country
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Australia
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Phone
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+61383739706
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Fax
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Email
57407
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[email protected]
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Contact person for scientific queries
Name
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Ken Bradstock
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Address
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Westmead Hospital
Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145
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Country
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Australia
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Phone
57408
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+612-9845 7073
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Fax
57408
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Email
57408
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effects of intensive induction and consolidation chemotherapy with idarubicin and high dose cytarabine on minimal residual disease levels in newly diagnosed adult precursor-B acute lymphoblastic leukemia.
2016
https://dx.doi.org/10.1016/j.conctc.2016.06.004
N.B. These documents automatically identified may not have been verified by the study sponsor.
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